Minimum Data Set (MDS) nursing home quality indicators (QIs) have been used for a variety of purposes by a variety of audiences. Yet, despite prolonged and intense examination, the concept of how to use quality indicators to draw conclusions about nursing homes is still in its infancy. Researchers tend to use a large number of measures without focusing on how they work together and offering little comment on how they can be used to compare one facility to another. This project aims to address some of these deficiencies by creating a classification of nursing homes based on their performance along dimensions of quality. This research could aid current efforts to link nursing home reimbursement to quality incentives, and to provide better summary information on quality to consumers. The specific aims of this study are as follows: 1) To evaluate the underlying dimensions of risk adjusted quality care indicators using several model candidates including: 1) process/outcome domains 2) Quality Indicator (Ql) content domains and 3) medical/nursing origin of the MDS Qls. 2) To create a categorization of nursing homes based on their functioning on the dimensions created in Specific Aim 1. 3) To evaluate and test this categorization by comparing the clusters with regard to the structural/organizational aspects of the nursing homes. The data for this study come from a project which examines the relationship between the amount of nursing effort and quality of care achieved in a nursing home. MDS records for all Minnesota nursing homes in 2003 will be examined. Statistical approaches include confirmatory factor analysis, two stage cluster analysis, MANOVA and regression.